The proposed Health Information Technology Center for Education and Research on Therapeutics on Health Information Technology (HIT-CERT) will cover a range of issues relating to the impact of HIT on therapeutics, building both on the prior work of our CERT, as well as addressing important new areas. In particular, we will build on our work in leveraging HIT for pharmacosurveillance, medication reconciliation, and medication-related clinical decision support, and identify new ways to utilize information coming from medication-related decision support to advance our understanding of how providers are responding to it. We propose to carry out 4 research projects over a five-year period, each of which will address one or more of the programmatic interest areas identified in the CERT RFA, with our areas of focus being patient safety, development and enhancement of tools, health care system interventions, and translation into practice or policy. The four proposals will involve 1) leveraging new technologies to improve pharmacosurveillance;2) making substantial improvements to an electronic medication reconciliation tool;3) using new sources of data from clinical decision support to identify physician-level variation and use these results to improve safety and efficiency;and 4) directly improving medication-related clinical decision support In addition, the HIT-CERT will establish two cores that will support the 4 projects, and which will also enhance our ability to provide rapid response by our multidisciplinary team to requests by the AHRQ program staff and CERT steering committee. The cores will include a methodology/data resources core, and a translation/dissemination core. The proposed HIT-CERT will possess a number of important strengths': a strong and experienced investigator team with deep expertise in the areas of therapeutics and HIT and a long track record of collaborative activities;expertise across a wide range of disciplines, including medical informatics, medicine, nursing, pharmacy, pharmacoepidemiology, clinical epidemiology, biostatistics, health services research, health care policy, and educational theory and research;access to a broad range of electronic health record (EHR), e-prescribing, clinical decision support-related, and clinical data;and strong partnerships with key stakeholders at the national and regional level, to enable us to improve therapeutics in a variety of ways. We believe that this work will help in realizing some of the benefits from the large investment in HIT that the U.S is currently making. PUBLIC HEALTH RELEVANCE: The nation is adopting HIT and electronic prescribing at a rapid pace, and is at the same time faced with enormous challenges because of the high costs and suboptimal care quality. It is therefore imperative that we build our understanding of how HIT in general and electronic prescribing in particular work and do not work, and advance ways it can be leveraged most effectively to improve safety, quality, and efficiency. In particular, developing approaches that leverage medication-related decision support will be important.